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Related Concept Videos

Drugs for Treatment of Ulcerative Colitis in IBD01:29

Drugs for Treatment of Ulcerative Colitis in IBD

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Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
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Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

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Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
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Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

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Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
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Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

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Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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Drugs for Peptic Ulcer Disease: Sucralfate as Mucosal Protective Agents01:24

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In the intricate landscape of the gastric lumen, excessive acid secretion disrupts the natural defense mechanisms, weakening the mucus-bicarbonate barrier. This vulnerability allows pepsin to infiltrate epithelial cells, digesting mucosal proteins and triggering erosion, leading to ulcer formation.
In this scenario, mucosal protective agents like sucralfate play an essential role. Sucralfate, a complex of sulfated sucrose and aluminum hydroxide, demonstrates its usefulness in acidic conditions,...
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Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

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Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
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Cytomegalovirus Colitis during Budesonide Therapy for Ulcerative Colitis.

Kana Tamazawa1,2, Masato Aizawa1, Jun Wada1,2

  • 1Department of Gastroenterology, Fukushima Medical University Aizu Medical Center, Japan.

Internal Medicine (Tokyo, Japan)
|January 14, 2026
PubMed
Summary

Budesonide MMX for ulcerative colitis (UC) did not prevent cytomegalovirus (CMV) colitis in one patient. Early CMV testing is crucial if UC worsens during budesonide MMX treatment.

Keywords:
budesonide MMXcytomegalovirus colitisulcerative colitisvalganciclovir

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Area of Science:

  • Gastroenterology
  • Virology
  • Pharmacology

Background:

  • Budesonide MMX is a treatment for mild-to-moderate ulcerative colitis (UC).
  • Cytomegalovirus (CMV) colitis can occur even during budesonide therapy.

Purpose of the Study:

  • To report a case of CMV colitis emerging during budesonide MMX treatment for UC.
  • To highlight the importance of considering CMV reactivation in worsening UC cases.

Main Methods:

  • Case report of a 69-year-old woman with left-sided UC.
  • Clinical presentation: worsening diarrhea and hematochezia during budesonide MMX therapy.
  • Diagnostic methods: colonoscopy, CMV pp65 antigenemia testing, and immunohistochemical staining of biopsy specimens.

Main Results:

  • The patient developed CMV colitis despite budesonide MMX treatment.
  • CMV pp65 antigenemia was positive, and biopsy confirmed CMV infection.
  • Treatment with valganciclovir led to rapid clinical improvement and viral clearance.

Conclusions:

  • Locally acting budesonide MMX does not eliminate the risk of CMV colitis.
  • Viral reactivation (CMV) can occur during budesonide MMX therapy for UC.
  • Early CMV testing is recommended for UC patients experiencing clinical worsening on budesonide MMX to guide treatment decisions.